Get new jobs by email
$71.3k - $82.6k
...outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance... ...appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure...RiskFull timeWork experience placement- ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Analyze and synthesize data to make a significant impact on Medicaid...RiskRemote jobImmediate start
- ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Engage with data analysis to drive improvements in Medicaid risk...RiskRemote jobImmediate start
$75k - $85k
Overview We are currently seeking a highly motivated Risk Adjustment Coding Specialist II. This role will report to a Sr. Manager - Risk Adjustment... ...through informal discussion and overread assignments; support coder training and orientation as requested by manager May assist or...RiskWork at officeMonday to Friday- Job Description Job Summary The Analyst, Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to support Molina’s Prospective and Retrospective Interventions...RiskWork at office
$75k - $85k
Risk Adjustment Coding Specialist II (Central Maryland) Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1668 S. Garfield... ...informal discussion and overread assignments. Supports coder training and orientation as requested by manager. May assist or...RiskFull timeWork at officeMonday to Friday- ...accurately to maintain compliance, and minimize risk and denials. Contributes to overarching... ...to provider network regarding risk adjustment and coding updates related to risk adjustment... ...and experience. Certified Professional Coder (CPC). Certified Coding Specialist (CCS)....RiskWork at office
- ...South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary... ...the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient...RiskWork at office
To Help Everyone Health & Wellness Centers
Los Angeles, CA11 days ago $30 - $33 per hour
...Thursday - Friday Remote Part B ~ Wednesday - Friday Onsite / Monday - Tuesday Remote We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and...RiskHourly payFull timeCasual workWork at officeRemote workRelocation packageMonday to FridayFlexible hoursRegal Medical Group
Los Angeles, CA8 days ago- Overview Job Description Job Summary The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality for all lines of business, ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment...RiskContract workLocal areaImmediate start
- ...Job Description Job Description The Hospital Claims Adjuster is responsible for the adjusting of hospital risk claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospitals/IPAs. Research, reviews, and contacts...Risk
MedPOINT Management
Los Angeles, CAa month ago - ...Design scalable workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity. Technology... ...change management (training, SOPs, job aids, communications). Risk, Compliance & Quality: Ensure alignment to CMS, HIPAA, state regulations...Risk
- Job Summary The Risk & Quality Performance Manager position will support Molina’s Risk & Quality Solutions (RQS) team. This position... ...years of program and/or project management experience in risk adjustment and/or quality 2+ years of experience supporting HEDIS engine activity...RiskRemote jobWork at office
- ...to revolutionize the Medicare health assessment landscape by delivering high-quality, patient-centered care through innovative risk adjustment models. Operating across multiple states and rapidly expanding, Transtreme partners with health organizations and primary care...RiskFlexible hours
Transtreme
Long Beach, CA25 days ago - Overview Your Role The Risk Adjustment Retrospective Analytics team focuses on delivering complete and accurate analytics for chart review targeting, financial impact calculations, and data submission. The Actuarial Analyst, Consultant, will report to the Manager of Risk...Risk
$50k - $90k
...Implement the directives and objectives of claims management Adjust claims and conduct negotiations on behalf of the Company within... ...diverse team members to underwrite and process claims for the many risks our clients face. Headquartered in the UK, we have offices in...RiskFull timeTemporary workWork at officeGlobal Aerospace, Inc.
Los Angeles, CA7 days ago$79.04k - $126.88k
...ERM Data Analyst assists in the execution of F&M’s Enterprise Risk Management (ERM) data management goals. This role emphasizes data... ...calibration of Verafin FRAML models by recommending parameters adjustments backed by statistical evidence. Document tuning rationale and...RiskFull timeContract workImmediate start- Overview Job Description The AVP, Clinical Data Acquisition is a key Risk Adjustment (QI) leader within the organization enterprise wide. This position advises senior management, other corporate departments, and Molina health plans on Risk Adjustment/RADV data collection...RiskWork experience placementLocal area
- ...management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning, and issue/risk management. Knowledge/Skills/Abilities Ability to provide strategic leadership on projects while also managing multiple,...RiskFull timeWork experience placementRemote work
Molina Healthcare
Long Beach, CA23 days ago $95k - $140.6k
...Implementrisk management strategies to identify, assess, and mitigate risks associated with configuration management. Minimum Qualifications... ...several projects at any given time, and the flexibility to adjust for abrupt changes in strategic direction. Experience with...RiskPermanent employmentFull timeTemporary workFlexible hoursWeekend workAfternoon shift- ..., equipment, and budget, to support project initiatives. Monitor resource utilization and make adjustments as needed to optimize project efficiency and effectiveness. Risk Management: Identify potential risks and issues that may impact project delivery and develop mitigation...RiskFull time
InterDent Service Corporation
El Segundo, CA24 days ago - ...management includes estimating, scheduling, costing, planning and issue/risk management. KNOWLEDGE/SKILLS/ABILITIES Manage project scope, schedule, and budget, making necessary adjustments as needed Tracks and supports planned vs actual budget including all costs...RiskFull timeWork experience placementNight shift
- ...collaboration. Develop and implement strategic planning initiatives to align with organizational goals. Communicate project status, risks, and issues to stakeholders and senior management. Resolve conflicts and address any challenges that arise during project...RiskOngoing contractLocal areaRemote workRelocation
CyberCoders
Carson, CA3 days ago - ...applicable laws, regulations, and industry standards. Implement and enforce best practices in design processes, sustainability, and risk management. Team Leadership and Development Lead and mentor design teams, fostering creativity, innovation, and professional...RiskFor contractors
CTI Environmental, Inc.
Long Beach, CAa month ago - ...Timberline accounting system. Maintains budget throughout projects, adjusting budget as necessary to ensure accuracy. Prepares Schedule of... ...owner’s representatives. 7. Primary responsibility for the risk management and documentation of projects: Sets up a...RiskFull timeContract workFor subcontractorWork at officeLocal areaMonday to FridayAfternoon shift
Nautilus General Contractors
Los Angeles, CA28 days ago - ...outcomes and assign follow-ups to ensure technical alignment and risk mitigation. Issue Resolution: Maintain a live project issue... ...consistent, data-driven updates to executive and technical stakeholders; adjust strategies and timelines as needed based on risk and performance...RiskRemote work
Totex Manufacturing Inc
Torrance, CAa month ago - ...Job Summary Molina Risk & Quality Solutions (RQS) works with health plan risk & quality leaders to support implementation of best... ...management responsibilities ~ Proven experience in risk adjustment, quality, and provider engagement. ~ Demonstrated ability to...RiskFull time
Molina Healthcare
Long Beach, CA23 days ago - ...deadlines are met without compromising on quality or safety. Risk Management: Identify potential risks or challenges during... .... Facilitate customer walkthroughs and handle any final adjustments or questions. Provide post-installation support, including addressing...RiskFor contractorsWork at officeLocal area
Powerful Solar
Los Angeles, CA3 days ago $176k - $225.5k
...and provide visibility to cross-functional teams. Programmatic Risk Management :Identify and manage program risks (time, requirements... ...robust, scalable solutions Experience communicating effectively, to adjust approach across stakeholders and teams and to navigate both...Risk- Overview The Director, Clinical Data Acquisition for Risk Adjustment is responsible for the implementation, monitoring, and oversight of all... ...be preferred for specific roles) • Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you are interested in...RiskImmediate start
